Age-related macular degeneration (AMD) is a chronic eye disease that affects central vision and most commonly appears in people aged 50–60 years old, as part of the natural ageing process of the eye. As this degeneration progresses, it can make everyday tasks such as reading, driving or recognising faces difficult, causing progressive loss of central vision. However, it is important to clarify something important from the outset: AMD does not usually affect peripheral vision, so it does not normally cause ‘total blindness’, but it can greatly reduce the independence and quality of life of many people, especially in older age groups.
The good news is that, although there is currently no definitive cure for all patients, there are early detection strategies and effective treatments (especially for the wet form) that can stabilise vision and slow the progression of deterioration if acted upon in time through responsible monitoring. Understanding what this disease is, how it manifests itself and what options are available today to control it is key to early detection and a better long-term approach.
What is AMD or Age-Related Macular Degeneration?
AMD is a degenerative disease that affects the macula, a small but essential area of the retina responsible for precise, detailed vision and adequate visual acuity. In simple terms: if the retina were a screen, the macula would be the ‘point of maximum resolution’. Therefore, when this area is damaged, the first thing that is usually affected is what we look at directly: letters, faces, signs or fine details.
The disease can progress slowly (more typical of dry AMD) or relatively quickly (more typical of wet AMD). In advanced stages, symptoms such as crooked lines, a blurred central area or even ‘spots’ without vision often appear, reflecting a greater loss of central vision.
What is the macula of the eye and what is its function?
The macula is located in the centre of the retina of the eye and is responsible for providing us with sharpness, central vision and good colour perception. Within the macula is the fovea, which has a high density of photoreceptor cells and allows us to see with great precision and resolution.
This translates into very practical skills for people’s daily lives:
• Reading comfortably
• Recognising faces
• Focusing at close range
• Appreciating details (e.g. in images, on screens or when cooking)
When the macula deteriorates, patients may notice that they need more light to see well, that they have ‘difficulty’ focusing, or that what they are looking at becomes blurred or distorted. This distortion, as if straight lines were wavy, is particularly important because it can be a warning sign of early changes.
How does AMD develop? Pathophysiological process
AMD does not appear overnight: it is usually the result of multifactorial causes and changes that accumulate over time. Clinical sources describe a process influenced by the ageing of retinal cells, oxidative stress, the accumulation of waste products and alterations in the normal “maintenance” of the retina, with possible genetic predisposition.
In many people, drusen, small deposits under the retina, form. Drusen, by themselves, do not always imply severe vision loss, but they are considered a marker of age-related changes and an increased risk of developing more advanced forms of the disease, especially when they are numerous or large.
In dry AMD, the damage tends to be more gradual and can progress to retinal layer atrophy. In wet AMD, the key mechanism is the growth of abnormal blood vessels (neovascularisation) under the retina, with the appearance of new blood vessels that can leak fluid or blood, damaging the macular structure more rapidly.
Types of Age-Related Macular Degeneration
In clinical practice, we mainly talk about dry AMD and wet AMD. Although they share the same ‘stage’ (the macula), they behave differently and go through different stages, with different treatment options for degeneration, especially in the wet form.
Dry (atrophic) AMD
Dry AMD, also called atrophic AMD, is the most common form, accounting for approximately 80–90% of cases. It is characterised by:
• Progressive thinning of the macula
• Presence of drusen
• Slow progression over many years
Vision loss is usually gradual, and many people do not notice significant changes in the early stages.
Wet (exudative) AMD
Wet AMD, also known as exudative AMD, is less common but can be more aggressive. It occurs when abnormal blood vessels grow under the retina, which can leak fluid or blood.
Its main characteristics are:
• Rapid progression
• More pronounced visual impairment
• Greater risk of central vision loss
The advantage is that, unlike the dry form, this form does have treatments with solid evidence.
Symptoms of AMD: how vision loss manifests itself
AMD mainly affects central vision. In the early stages, it may go unnoticed or be attributed to ‘eyestrain’, but there are signs that you should be aware of and monitor through appropriate tests:
• Straight lines that appear wavy
• Blurred area near the centre of vision
• Blind spot or central blurring that cannot be corrected with glasses
• Less vivid colours and difficulty in low light
If you experience these symptoms, early assessment by an ophthalmologist may be key, especially in wet AMD.
Consequences of macular degeneration in daily life
Macular degeneration can significantly affect personal autonomy. Everyday activities such as reading, driving, cooking or using electronic devices can become more complex for patients.
Although it does not cause total blindness, the loss of central vision can lead to functional dependence, social difficulties and emotional impact, with a direct impact on quality of life, especially in older people. The use of optical aids and visual support is extremely useful.
Diagnosis of AMD and early detection
The diagnosis is made by an ophthalmologist or specialist combining clinical examination and testing with various imaging tests:
• OCT (Optical Coherence Tomography): allows the retina to be viewed in layers and changes in the macula to be detected with high resolution.
• Amsler grid: a simple self-monitoring tool for detecting visual distortions.
The grid is useful for patients to detect early changes between check-ups.
Risk factors and profile of affected individuals
Age is the main risk factor for AMD, especially after the age of 60. However, there are other factors that influence its onset:
• Family history
• Smoking
• Prolonged exposure to sunlight
• Unbalanced diet
These factors increase the risk of developing macular degeneration and justify responsible visual monitoring.
Medical treatment of AMD: current options
The treatment of macular degeneration depends on the type and stage of the disease.
• In dry AMD, there are no curative medications, but risk factors can be monitored and controlled.
• In wet AMD, intraocular injections of anti-VEGF drugs are used to act on abnormal blood vessels, helping to stabilise vision.
Prevention and self-care in macular degeneration
It is not always possible to prevent AMD, but certain habits help to reduce the impact of ocular ageing:
• Avoid smoking
• Maintain a balanced diet
• Control cardiovascular factors
• Protect your eyes from sunlight
Self-monitoring with a grid and check-ups with an ophthalmologist are key.
Nutritional support and supplements in AMD
Nutritional support can form part of the overall approach to AMD, especially in dry AMD in intermediate stages. Formulas based on the AREDS2 study include nutrients such as antioxidant vitamins, zinc, lutein and zeaxanthin.
The AREDS2 study demonstrated that a specific nutritional supplement formula reduces the risk of progression from dry age-related macular degeneration (AMD) to advanced stages by 25%.
These ingredients contain properties that positively address AMD:
Vitamins A and E
• Protect against age-related macular degeneration (Pameijer 2022)
• Supplementation protects against high myopia (Mikoluc 2024)
• Vitamin A supplementation has been associated with a low prevalence of glaucoma (Han 2022)
Lutein and Zeaxanthin
• Improve the production, stability and quality of tears (Radkar et al 2021 and Goia et al 2024)
• They reduce damage to the ocular surface and inflammation (Radkar et al 2021 and Goia et al 2024)
• They improve ocular fatigue and dryness, as well as macular function (Kan et al 2020)
• Delay the development and progression of age-related macular degeneration and diabetic retinopathy (Li et al 2020)
• Alleviate premature retinopathy, myopia and cataracts (Li et al 2020)
Astaxanthin
• Protects the retina against damage caused by blue light, free radicals and UV rays (Tian et al 2022)
• Antioxidant effect and improvement of dry eye syndrome (Tian et al 2022)
• Improves eye fatigue and dryness as well as macular function (Kiwaza et al 2021)
• Improves visual function (Piarmarocchi et al 2012)
It is important to remember that:
• Supplements do not cure AMD
• They are not a substitute for medical treatment
• Their use must be assessed on an individual basis
Advances and future prospects in the treatment of AMD
AMD is a very active area of research. In recent years, strategies have been promoted to:
• Reduce the frequency of injections in wet AMD (longer-lasting drugs),
• Improve monitoring with imaging technology,
• Explore new therapeutic targets, especially for dry AMD.
Recent clinical guidelines and summaries highlight that progress has been remarkable, especially in the wet form, thanks to anti-VEGF therapy, and the field continues to advance in guidelines and molecules.
Frequently asked questions about age-related macular degeneration
Is there a cure for AMD?
Currently, there is no definitive cure for all cases. In the wet form, there are effective treatments to slow progression and stabilise vision, and in some cases improve it.
Does macular degeneration cause total blindness?
It usually affects central vision and peripheral vision is maintained, so it does not usually cause total blindness.
Does AMD affect both eyes?
It can affect both, sometimes at different rates of progression.
Can macular degeneration be treated with surgery?
There is no cure for this condition; the main treatment is medication for the wet form and maintenance treatment for the dry form.
Do glasses help with AMD?
They can help to some extent, but if the macular damage is significant, low vision aids and adaptations may be required.
Are AMD and cataracts related?
They are different conditions and can coexist due to age, but they are not the same.
How often should I have my eyes checked if I have AMD?
It depends on the type (dry/wet) and the stage. This is determined by the ophthalmologist, and in the wet form, monitoring is usually more frequent.
Conclusion and practical habits
AMD is a common disease after a certain age and can have a major impact on daily life because it affects central vision. Even so, understanding the symptoms and acting quickly when changes occur (such as distorted vision or a central spot) can make a big difference, especially in wet AMD, where there are treatments with solid evidence. In the case of dry AMD, it is important to monitor the condition and improve your diet with specific antioxidants.
If you want to support your long-term eye health, commit to a balanced diet, regular check-ups and informed decisions based on evidence.
This content is informative and does not replace the advice of a healthcare professional.
Scientific references
Pameijer EM, Heus P, Damen JAA, et al. What did we learn in 35 years of research on nutrition and supplements for age-related macular degeneration: a systematic review. Acta Ophthalmol. 2022 Dec;100(8):e1541-e1552. doi: 10.1111/aos.15191.
Mikoluc B, Sawicka-Powierza J, Berk K, et al. Reduced retinol (vitamin A) and α-tocopherol (vitamin E) blood levels and increased myeloperoxidase (MPO) activity in children with high myopia. Sci Rep. 2024 Sep 11;14(1):21231. doi: 10.1038/s41598-024-72426-8.
Han FF, Fu XX. Vitamin intake and glaucoma risk: A systematic review and meta-analysis. J Fr Ophtalmol. 2022 May;45(5):519-528. doi: 10.1016/j.jfo.2021.10.010.
Radkar, P., Lakshmanan, P. S., et al. (2021). A Novel Multi-Ingredient Supplement Reduces Inflammation of the Eye and Improves Production and Quality of Tears in Humans. Ophthalmology and therapy, 10(3), 581–599. https://doi.org/10.1007/s40123-021-00357-y
Gioia, N., Gerson, J., et al. (2024). A novel multi-ingredient supplement significantly improves ocular symptom severity and tear production in patients with dry eye disease: results from a randomized, placebo-controlled clinical trial. Frontiers in ophthalmology, 4,1362113. https://doi.org/10.3389/fopht.2024.1362113
Kan, J., Wang, M., et al. (2020). A novel botanical formula improves eye fatigue and dry eye: a randomized, double-blind, placebo-controlled study. The American journal of clinical nutrition, 112(2), 334–342. https://doi.org/10.1093/ajcn/nqaa139
Li, L. H., Lee, J. C., et al. (2020). Lutein Supplementation for Eye Diseases. Nutrients, 12(6), 1721. https://doi.org/10.3390/nu12061721.
Tian, L., Wen, Y., et al. (2022). Benefits and Safety of Astaxanthin in the Treatment of Mild-To-Moderate Dry Eye Disease. Frontiers in nutrition, 8, 796951. https://doi.org/10.3389/fnut.2021.796951
Kizawa, Y., Sekikawa, T., et al. (2021). Effects of anthocyanin, astaxanthin, and lutein on eye functions: a randomized, double-blind, placebo-controlled study. Journal of clinical biochemistry and nutrition, 69(1), 77–90. https://doi.org/10.3164/jcbn.20-149
Piarmarocchi, S., Saviano, S., et al. (2012). Carotenoids in Age-related Maculopathy Italian Study (CARMIS): two-year results of a randomized study. European journal of ophthalmology, 22(2), 216–225. https://doi.org/10.5301/ejo.5000069
